NPIMap

Organization Active NPI

Northern Arizona Healthcare Corporation

  • Interventional Cardiology Physician
  • Cottonwood, AZ
National Provider Identifier
1861176166
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
NORTHERN ARIZONA HEALTHCARE CORPORATION
Practice address
269 S Candy LN Ste 2C
Cottonwood, AZ 86326-4158
Phone
(928) 634-1331
NPI assigned
Jun 15, 2023
Organization subpart
Yes
Parent organization
NORTHERN ARIZONA HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Cofield
Title
Chief Operating Officer
Phone
(928) 773-2010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

269 S Candy LN Ste 2C
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6527

Other names 1

  • Northern Arizona Healthcare Medical Group Cardiology-Cottonwood Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2129104Northern Arizona Healthcare Medical Group-269 S Candy Lane Ste 2C, Cottonwood, AZ 86326Certificate of waiverApr 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northern Arizona Healthcare13 organizations share this tax ID, including this one
Part of
Northern Arizona Healthcare

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1861176166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN STE 2C",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-634-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA HEALTHCARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN ARIZONA HEALTHCARE CORPORATION",
        "enumeration_date": "2023-06-15",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "COFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "928-773-2010"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Arizona Healthcare Medical Group Cardiology-Cottonwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Arizona Healthcare Medical Group Cardiology-Cottonwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.